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“To Promote Education in Cancer Imaging in the Multidisciplinary Management of Malignancy”

Home > Articles

Whole-body MRI and PET/CT in bone metastases Open Access Article

Abstract

Bone metastases are important sequelae of many types of cancer indicating poor prognosis and reduced quality of life when becoming symptomatic, e.g. by pain, anaemia, fractures or neurologic complications. Early detection consequently has a significant impact on individual patient management. [18F]Fluorodeoxyglucose (FDG)-positron emission tomography (PET) detects areas of the bone with increased glucose consumption by the tumour. Magnetic resonance imaging (MRI) identifies areas where normal bone marrow is replaced by tumour tissue. Computed tomography (CT) detects secondary induced bone turnover leading to osteoblastic and/or osteloytic bone structure. Because high-resolution whole-body imaging by PET/CT and MRI are relatively new technologic achievements, large multicentre clinical trials comparing their accuracy for different tumour types are not yet available. But clinical reports to date indicate that PET and CT are of comparable accuracy in cases of previously untreated metastases and CT is more sensitive after pre-treatment. Combined PET/CT seems to be superior because [18F]FDG-PET and CT are complementary in the assessment of osteoblastic and osteolytic metastases. Sensitivity and specificity of PET/CT may be increased with the application of other radiotracers, e.g. [18F]fluoride, particularly due to the detection of both increased regional blood flow and bone turnover. Initial clinical trials are currently underway. MRI has been proven to be more sensitive than conventional bone scintigraphy, X-ray, CT and PET/CT in different tumour types, but strongly dependent on the tumour type. Whole-body MRI is a novel and promising technique that may be the most sensitive whole-body method for detecting bone metastases, but to date it is available in only a few radiological centres.

Author

Heinz-Peter Schlemmer

Contact Details

Corresponding address:
Dr Heinz-Peter Schlemmer, Department of Diagnostic Radiology,
University Hospital, D-72076 Tuebingen, Germany

Reference

ICIS Cancer Imaging Volume 7 Special Issue A
DOI: 10.1102/1470-7330.2007.9005

Date Posted

1 October 2007

Open Access Article Open Access is provided for this article.

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